Unfractionated heparin reversal: Difference between revisions
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==Background== | ==Background== | ||
*Managed according to clinical severity, NOT PTT value | *Managed according to clinical severity of bleeding, NOT PTT value | ||
**Heparin-associated bleeding is not always reflected by a supratherapeutic PTT | **Heparin-associated bleeding is not always reflected by a supratherapeutic PTT | ||
== | ==Indications== | ||
*Significant bleeding while on [[heparin] drip | |||
==Management== | ==Management== | ||
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**Give slowly over 1-3min; do not exceed 50mg in any 10 minute period | **Give slowly over 1-3min; do not exceed 50mg in any 10 minute period | ||
**Because half-life is short (7 min) may require second treatment | **Because half-life is short (7 min) may require second treatment | ||
*Massive bleed | *[[hemorrhage|Massive bleed]] | ||
**Cryoprecipitate (10 U IV), then [[FFP]] (& platelets, aminocaproic acid infusion if nec) | **[[Cryoprecipitate]] (10 U IV), then [[FFP]] (& platelets, aminocaproic acid infusion if nec) | ||
==Disposition== | ==Disposition== | ||
Revision as of 19:03, 1 October 2019
Background
- Managed according to clinical severity of bleeding, NOT PTT value
- Heparin-associated bleeding is not always reflected by a supratherapeutic PTT
Indications
- Significant bleeding while on [[heparin] drip
Management
- Stop transfusion
- Observation alone may be appropriate in less severe cases
- Protamine
- Only indicated for major bleeding (0.2% of patients develop severe anaphylaxis)
- Give 1mg IV for every 100 units of UFH infused in the prior 3hr
- Give slowly over 1-3min; do not exceed 50mg in any 10 minute period
- Because half-life is short (7 min) may require second treatment
- Massive bleed
- Cryoprecipitate (10 U IV), then FFP (& platelets, aminocaproic acid infusion if nec)